n U
e d
t r
e h
t n
e t
1
Contents page Foreword......................................................................................... 5 Child-friendly space ....................................................................... 8 Medical tents: Hospitals................................................................. 20 Medical tents: Health posts............................................................ 38 Radio Sindhu.................................................................................. 50 Temporary learning centres.......................................................... 56 Shelter homes................................................................................. 67 Bhukampa........................................................................................ 88 Phutkar:Tent for various purposes.................................................. 91
4
Foreword Tents. They were the most visible items after the earthquakes of 2015. Whether they were makeshift shelters
that sprouted in open spaces in Kathmandu, or proper tents that were set up to provide essential services to the people affected by the earthquakes, tents became a ubiquitous sight in post-earthquake scenario in Nepal. With more than 750,000 homes destroyed or damaged, the people living in the earthquake affected districts in the hills of western, central and eastern development regions of the country were forced to take shelter either in camp settings, or had to live in makeshift shelters next to the rubble of their homes. With 80 per cent of the health posts and schools damaged or destroyed services had to be set up for children under tents or tarpaulin roofing. Families spent the hot summers, the wet monsoons and the cold winters in temporary living spaces. Girls and boys played under the tents of child-friendly space that were set up to keep them safe from harm, to engage them, and help them get over their trauma. With more than 35,000 classrooms destroyed, these children have been studying under temporary learning centres for the past year. They may not have provided the most conducive environment for teaching learning, but at least the schoolchildren came back to their routine within six weeks of the first earthquake. The most visible tents in the Kathmandu valley were those provided to hospitals by UNICEF. These huge white tents could be seen in the courtyards and parking lots of all major hospitals for many months. The continuous rocking due to strong aftershocks in the first two months meant neither patients nor medical staff felt safe inside buildings. As a result, not just outpatient departments, but treatments, as well as surgeries were held under these tents. All of these centres were equipped with emergency medical, midwifery and surgical kits. The tents that are being used even a year after the quake are those set up in health posts that were totally damaged by the quakes. Similarly, tents provided to shelter women waiting for labour or after they delivered their babies in 11 districts most affected by the earthquake are still being used. These shelters provided a safe and caring environment for women and their babies, as well as their caretakers. All of them were provided with hygiene kits, and four meals a day, free of cost. When winter set in, and when fuel crisis gripped the nation, these shelter homes were further outfitted to protect those who stayed there from the cold, and blankets were distributed to keep children and women warm. This pictorial publication has been produced to highlight the services provided by various tents whether they housed the child-friendly spaces, the temporary classes, medical services, shelter homes or radio stations. But more than the services, it focuses on the people – the children, adolescents, men and women who lived, took shelter, provided or availed of services under the tents. Tomoo Hozumi Representative, UNICEF Nepal
6
When the earthquake struck on 25th April 2015, it razed to the ground, or damaged hundreds of thousands of homes mainly made of mud mortar and stones. Due to recurring aftershocks people took refuge in makeshift shelters next to their damaged homes, or in clusters in any available open space. Schools had been damaged, and were closed, parents were busy trying to salvage their belongings and trying to piece back their lives, and the children had nowhere safe to go. That is when UNICEF with its partners set up simple, bamboo and tarpaulin, child-friendly spaces. These were spaces where children could come and be children, have fun, play games, learn and forget their trauma. These spaces offered them a sense of routine and normalcy. Following the earthquake UNICEF helped to establish 244 child-friendly spaces, equipped with recreational kits and other supplies as well.
7
Child-friendly spaces â–˛ After the devastating earthquake, thousands of homes and schools across 14 districts were destroyed, forcing people to take shelter in open grounds. In Kathmandu city, most of the mid-city dwellers congregated in Tundikhel - the large parade ground - and within a week Tundikhel had become a tented city. In the first week itself, UNICEF helped to set up a child-friendly space made of bamboo and tarpaulin in Tundikhel.
8
► Made quickly with locally available resources such as bamboos and tarpaulins, the childfriendly spaces provided the children with safe and protective space to play and participate in learning and recreational activities under adult supervision. This offered them a sense of routine and normalcy amidst chaos and uncertainity.
▼ Once the child-friendly spaces tent was set up and equipped with recreational and educational materials, it became children’s favourite space in Tundikhel.
9
â–˛Before the UNICEF tents arrived, child-friendly spaces were setup swiftly under tarpaulins. This one is set up in the grounds of the Shree Siddhi Kamaladevi Secondary School of Pipaldanda in Sindhupalchowk District. A portion of the school which was heavily damaged by the earthquake can be seen in the back.
10
â–˛Once the tents arrived, they provided a much more secure child-friendly space, like this one with happy little girls and boys in Ghola village in Dhading District.
11
â–˛ At the child-friendly spaces, like the one above in Kavrepalanchowk District, in Tundikhel, trained psychosocial counsellors helped children, who needed it, recover from the traumatic experience of the earthquake and its numerous aftershocks.
12
â—„ Five days after the earthquake of 25th April, young and older children engage themselves in fun activities under the Child-friendly spaces tent in Tundikhel.
â—„ Sajan, 12, smiles and displays his paper work which he made himself in child-friendly space in Tundikhel.
13
14
â–˛ A month after the earthquake, Kuisang Rumba, a Tamang actor, dances with young children at a UNICEF-supported child-friendly space in Charikot, the district headquarters of Dolakha.
â—„ Children peep out through a tent of UNICEF supported child-friendly space tent in Harre village in Sindhupalchowk District.
15
16
â—„ The child-friendly spaces provided an opportunity for children to be away from the tension and travails their families faced in the aftermath of the earthquake. The facilitators in these spaces, like the one featured here in Ghola village in Dhading District, helped the children to learn, have fun and play games.
17
18
The earthquakes damaged and destroyed overall 1200 health facilities including health posts and hospitals. Even if the structures of the hospitals, like those in Kathmandu Valley, were not damaged, the occupants of these institutions - medical staffs and patients alike - were too rattled by the incessant aftershocks to stay indoors. Medicle services, therefore, spilled into open spaces, including streets. UNICEF supported the Government in establishing 10 emergency care sites and restoring health services by providing 326 tents of various sizes to help facilities in and around Kathmandu. These medical tents were equipped with emergency health kits, sets of surgical equipment as well as midwifery kits. For over two months hospitals in Kathmandu Valley were conducting their services, including surgeries, under these tents.
19
Medical Tents: Hospitals
20
â–ş The debris-filled room of the Nuwakot District Hospital, one of the five hospitals rendered unusable by the earthquake.
21
â–˛ Hospital ward under a tent at the Teaching Hospital in Kathmandu a few days after the earthquake.
22
â–ş Multiple surgeries under way under a tent in Patan Hospital, Lalitpur District. Equipment from operating theatres in the second and third floors of this hospital were relocated to these tents. Surgeries - including for the orthopedics and caeserian sections were carried out round the clock.
23
â–ź Two months after the earthquake, a nurse tends to 75 year old Ganga Devi under a medical tent at the Birendra Police Hospital in Kathmandu.
24
â–ş The makeshift operation theatre under a tent at the Birendra Police Hospital in Kathmandu.
â–ş Arati Mainali receiving treatment under a medical tent at Birendra Police Hospital in Kathmandu, while her son watches nearby
25
26
â—„ Patients under a UNICEF-supported tent in the premises of the Orthopedic Hospital at Jorpati in Kathmandu. Over 22,000 people were injured during the earthquakes of 25 April and 12 May 2015.
27
► A month after the earthquake, UNICEF-provided tent being set up in Spinal Injury Rehabilitation Centre at premises in Kavrepalanchowk District. The tent helped provide the 51-bedded rehab center with extra space to treat the increased number of patients with spinal injury in the aftermath of the earthquake. ▼ Two girls undergoing rehabilitation for their earthquake-related injuries at the Hospital and Rehabilitation Centre for Disabled Children in Kavrepalanchowk District. Since the hospital suffered from damage from the earthquakes of April and May 2015, children and their parents initially slept under UNICEF medical tents.
28
► Treatment under the tent in Sindhupalchowk District, where this UNICEF medical tent was among the many other tents that functioned as the emergency hospital site managed by the Norwegian Red Cross in Chautara, the district headquarters.
29
â–ź Binda Dhungel carries her five-year-old daughter Bismita outside a medical tent in Bhimeshwar Municipality, district headquarters of Dolakha. Bismita and her three-year-old brother Bibek were playing outside their house in Magpauwa village, when the 7.3 Richter scale earthquake struck on 12th May. The children were buried under the rubble of the collapsed house and it took Binda an hour to dig them out. It took her another three hours to bring the injured children to the district headquarters for treatment.
30
â–ş A son helps his mother with a sling to support her fractured hand under a UNICEF tent in the premises of Dhading District Hospital.
31
â–˛ A girl injured during the 25 April earthquake lies in a cot in between a cluster of tents provided by UNICEF for makeshift hospital in Nukawot District.
32
â–ş A woman recieving treatment under a UNICEF-provided tent looks out of the tent in Bhimeswar Municipality, district headquaters of Dolakha.
33
â–˛ A week after the 12 May earthquake, a young child is treated under a UNICEF-provided tent in the premises of the Dolakha District Hospital in Bhimeswar Municipality.
34
â–ş Kritagya Adhikari, 6, with a cast over his left arm, rests under one of the two tents provided by UNICEF for Dhading District Hospital in Dhading Besi, the district headquarters.
35
The earthquake destroyed 417 healthposts and 12 Primary Health Care Centres, like the one in Dhading District pictured here. UNICEF supported the continuation of medical services for the affected people by providing tents to these health posts, and also equipped them with emergency health kits, surgical equipment as well as midwifery kits.
36
37
Medical Tents: Health Posts
38
This is the story of Mas Maya Gurung who came to seek medical treatment for her son Abhinash at the makeshift health centre in Arughat in Gorkha District. Mas Maya Gurung, 35, of Majhgaun village in Gorkha came to the Primary Health Care Centre (PHCC) in Arughat with her 3-year-old son Abhinash, eight days after he broke his leg while playing football. It took Mas Maya that many days to gather the NRs. 250 (approx. USD 2.5) to bring her son for treatement. Abhinash recieved necessary care and treatement at the PHCC which is still functioning under tents mainly provided by UNICEF. The tented health facility was set up after the brand new PHCC building was badly damaged by the 2015 earthquake.
39
When health posts, like the one pictured here in Chhyamawati in Dolakha District was destroyed by the earthquake , UNICEF provided medical tents so that the affected population could continue to avail of basic health sercives. In the following pages is the story of the journey of a medical tent from the warehouse in Kathmandu to Simjung village in Gorkha District.
42
Journey of a medical tent
â—„ The tents from the UNICEF warehouse overseas arrived by air and were initially stored in the warehouse at the Tribhuwan International Airport premises.
43
44
◄ Once the UNICEF medical tent and essential health supplies reached Gorkha Bazar, district headquarters of Gorkha, it was loaded onto a tractor headed for the tent’s final destination, Simjung village.
► The going is tough. The tractor has to traverse through next to impassable red mud tracks and needs to be coaxed back to its tracks. Else it has to cross many rain-swollen mountain streams.
45
â—„ Local porters carry the health supplies to Simjung.
46
â—„ The tent finally arrives in Simjung
â–˛ Setting up the medical tent in the premises of the Simjung health post to establish a birthing centre there.
47
â—„ There is a queue of patients waiting to avail services at the birthing centre once the tent was set up and equipped with medical supplies.
48
â—„ A Simjung health post staff Parbati Koirala uses a fetuscope to listen to fetal heartbeat in the newly established birthing centre.
â–˛ Sarita Gurung from Ghyawa village Simjung with her baby in front of the newly set up UNICEF-supported medical tent.
49
50
Radio Stations
The earthquakes of 2015, disabled about one-fifth of the over 300 community radio stations in the country. While the buildings housing 30 radio stations in 14 districts most affected by the earthquake collapsed, most others lost their equipment and their studios were also damaged. However, many of these broadcasters, understanding the urgency of keeping people informed during crisis regrouped together quickly and started broadcasting programmes from makeshift studios on the impact of the earthquake and on-going relief and response activities. UNICEF provided tents to house seven community radio stations, and also supported 16 stations with necessary rehabilitation supplies, including training local technicians on repairing damaged radio sets.
51
â–ź Radio Sindhu, a community-based FM station in Sindhupalchowk District was destroyed during the 25 April earthquake. Despite the setback, the radio station continued broadcasting, first from open ground and then from under a small tent. The tent did not have sufficent space, nor did it provide enough protection from the vagaries of mountain weather. UNICEF therefore provided the radio station with a larger tent that not only had adequate space, but also enabled them to disseminate important emergency related information to the community.
52
► Two weeks after the earthquake of 25 April, Tomoo Hozumi, UNICEF Representative to Nepal, is interviewed by Radio Sindhu about UNICEF’s response in the aftermath of the earthquake.
53
The earthquake of 25 April 2015 struck on a Saturday, when schools were closed, and there were no children in the classrooms. Across the 14 districts more than 35,000 classrooms were destroyed or damaged. Sticking to the priciple of ‘education saves lives’, UNICEF helped to set up nearly 1800 temporary learning centres so that schools could resume as early as possible and chlidren could bounce back into a routine and experience a sense of normalcy.
Temporary learning centres With the intention of getting the children back to school as soon as possible UNICEF, in collaboration with the Government and implenting partners, set up 1,793 temporary learning centres. These were simple structures made of locally available material, that would provide the children with safe place to study. Setting up temporary learning centre facilitated the return of children to education as schools reopened six weeks after the first quake. In the next phase, these structures will be upgraded into semi-permanent transitional learning centres that will last until more permanent school buildings can be built.
â—„â–ź Temporary learning centre under construction at Lamatar, village in Lalitpur District.
56
â–˛ A sturdier temporary learning centre, with the UNICEF tarpaulin roofing in Lalitpur.
57
◄ Group of children, with welcoming red ‘tika’ on their foreheads, follow meditation instructions in a temporary learning centre in Kuleshwor in Kathmandu on the first day of school after the earthquake. UNICEF had also provided teachers with Activity Book featuring practical guidance for teachers on psychosocial support and risk reduction messages.
58
◄ A student playing with colourful paper design in a temporary learning centre in Purano Naikap, Kathmandu.
► All smiles to be able to back in a normal routine under a temporary learning centre at Gaurishankar Lower Secondary School in Gairimudi village in Dolakha District.
► A boy with hearing disability, signs “I love you” under the temporary learning centre at Bhimeshwar Primary School in Mahankal, Dolakha District.
► Manjari Tamang, 7, is all smiles as she draws in her class under a UNICEF-supported temporary learning centre at Shree Mahankal Primary School in Charikot, the district headquarters of Dolakha.
59
60
â—„ UNICEF Executive Director Mr. Anthony Lake visits students at a UNICEF-supported temporary learning centre for earthquake affected children in Khokana of Lalitpur District.
61
â–˛ Students taking their School Leaving Certificate examination under the temporary learning centre at Kavresthali Secondary School in Kathmandu. The school, which was damaged by the earthquake and deemed unsafe, is now functioning under nine such temporary learning centres set up with support from UNICEF.
62
â–ş A boy with disability participates in a painting workshop organized by UNICEF and partners at Art Museum at Khagendra Navajivan Special Education Secondary School in Jorpati, Kathmandu.
â–ş A class in session in UNICEF-supported temporary learning centre in Gokarna, Kathmandu.
63
When the earthquake brought down health posts and the birthing centres there, the people it impacted most were pregnant women and their families. Since the time that a mother gives birth to a new life is a precious and intimate one, and a time when both mother and child need special care and protection, UNICEF through partners set up shelter tents in 11 districts outside Kathmandu Valley. These shelter tents, known as shelter homes, provided a safe and caring environment around the clock for pregnant and lactating women to stay just before and after delivery, together with continuous provision of care and services.
64
65
66
Shelter homes
â—„ Two months after the earthquake a mother holds her newborn under a mosquito net inside a UNICEF-provided tent in the District Hospital premises in Dhading.
67
68
At a time when there was destruction and hardship all around, the shelter homes became like oasis for pregnant women and new mothers. While most of them mothers stayed roughly for a week in shelter homes, Sanu (name changed) stayed on for a few months after the delivery of her son. She had nowhere to go. Born in a dalit family (traditionally marginalized community), Sanu dared to fall in love with a man from a so-called upper caste. Sanu became pregnant, but before the couple could tie the knot, and on the day their child was born, her man had to fly out to Qatar as a migrant worker. Alone and unaccepted by the families, Sanu and her baby stayed on at the shelter home. “We are loved and taken very good care here under the tent of the shelter home” said Sanu.“Here I am just a mother and my son is just a child, no one is botherd by my caste and marital status.” Sanu is currently living in rented quarters near the District Hospital and is getting by with the money she receives perodically from the father of her baby in Qatar. The care and support she received in the shelter home helped her stand on her feet and enabled her to take care of her son, now a bubbly child.
69
â–˛ Tent with a view in Manthali, Ramechhap District. Pushpa Gharti Magar, Kamala Tamang and Anju Adhikari (from left to right) who are medical staff on 24x7 attendance at the shelter home, enjoy a break in their living quarters, also under a tent.
70
► Pushpa Gharti Magar, medical staff at the shelter home in Manthali, Ramechhap District, helps change a baby. The baby’s older sister Sadiksha Poudel and mother Sumitra Poudel watch on. Mothers received love, care, and a bit of pampering in the shelter home.
► Mother and daughter under a shelter tent in Gorkha District, waiting for the arrival of a new member of their family.
71
â—„ When winter set in, the shelter tents were reinforced to protect the women and children from the harsh cold weather.
72
â—„ New mothers with their babies in a row in the shelter home in Jiri, Dolakha District.
â–˛ Pregnant, new and lactating mothers at shelter home in Melamchi, Sindhupalchowk District. In a year, a total of 11,000 women and children benefited from the 22 shelter homes established in 11 districts.
73
â–ź A nurse in the shelter home in the Dhading District recording the details of the new mother and her family.
74
â–ş Sunita, 17, lifts her mother Ram Maya Gurung, a pregnant paraplegic in the shelter home in Dhading District. Ram Maya recived support from the Human Touch Fund established by the staff of UNICEF Nepal to travel from her hometown in Dhading to Dhulikhel Hospital in Kaverpalanchowk District for the delivery. She bore a healthy daughter.
â–ş Ranjit Khadka, Rajkumari Gurung and Shanta Khadka (left to right), have been in the attentence 24x7 for 11 months at the shelter home in Gorkha District. Ranjit is one of the few males amongst the total 132 medical staff engaged in the shelter homes, and who seemed to enjoy the challenges of working in what is seen as a trditionally femaleoriented job.
75
â—„ Waiting for the next one, a pregnant woman walks with her baby around the shelter home in Dhading District.
â–ź The shelter homes also admitted sick children. Here a mother kisses her son at the threshold of the tent.
76
â–ş A month after the earthquake, when the shelter tent had just been set up, and the cots had yet to arrive, an exhausted new mother and her baby fast sleep on the mattress on the ground.
77
Sushila Phuyal was six months pregnant with her baby when the 25 April earthquake struck. Clutching her 2-day-old son in her lap, in a shelter home in Charikok in Dolakha District. Sushila, who joined Nepal Police four years earlier, reminisces about the aftermath of the earthquake. “During that time I was on duty in Birtadeurali of Kaverpalanchowk. When the quake struck we were immediately put on rescue mission. We dug out many corpses, including that of a pregnant woman and also a mother and child. But we also managed to dig out seven people alive from the rubble.” In a calm and unwavering voice she continues,“ I was in uniform, and it was my duty. I did not feel scared nor did I connect any of those deaths with my own delicate condition.” Sushila came to the shelter home 24 hours before delivery, and was in a hurry to get back home to her family including her 7-year old son. She was gifted baby clothes and family hygiene and dignity kit provided by UNICEF. Looking down at her newborn she says, “The only thing I wish for is that this little one will have an easier life than ours, and will not have to toil as hard!”
78
79
◄ A pregnant Chinda Magar looks on as her daughter has her morning meal in Manthali, Ramechhap District.
◄ A mother-in-law looks after her grandchild while the mother has her meal in Dolakha District
80
◄ Caring for the mother of his child in Rasuwa District.
â–˛ Kumari Shrestha has her meal with her newborn beside her in the shelter home in Manthali, Ramechhap District.
81
â–˛ Sushil Thapa who was brought in to the shelter home in Kapilakot in Sindhuli District due to his vulnerability, fared much better after being cared for at the shelter home. Here he is entertaining the mothers and the children by playing madal, the traditional drum.
82
â–ş Sibling love in the shelter home in Manthali, Ramechhap District.
83
84
â—„ Attending nurses in the shelter home in Charikot, Dolakha District, giving a baby a bath in the sun.
â–˛ Few tips to the children on the six steps of hand washing by the staff nurse in the shelter home in Dhading District.
85
86
◄ In the aftermath of the earthquakes in 2015, there was much death and destrution. But across the districts, babies were born on the day the earthquake struck, bringing a source of joy in an atmosphere otherwise filled with panic and fear. “Bhukampa” (meaning earthquake) is the story of one such special baby in Dhading District.
87
Bhukampa In the midst of all the destruction and death in Dhading district, there was life. On 25 April a child was born to 17-year old Rojina in the remote Nalang village. Nicknamed ‘Bhukumpa’ meaning earthquake the little one became the apple of the eyes for the community who looked upon the baby as an aspicious sign for many villagers. Rojina takes very good care of the little one and goes for regular check ups at the heath post functioning under a tent near her home.
88
89
90
Phutkar: Tents for various purposes
◄ None of the 14 districts most affected by the earthquake overlapped with the 15 “programme” districts that UNICEF was working in. In order to roll out emergency relief and response and life-saving activities across the areas of health; nutrition; water, sanitation and hygiene (WASH); education; child protetion; and social protection, UNICEF had to quickly set up several site offices. As it was difficult to find structures that had not been damaged by the earthquake in these damaged by the earthquake, in these districts, the first offices were set up under tents too. The tent featured here was the office in Chautara in Sindhupalchowk District.
91
◄ Office set up under the tent in Chautara in Sindhupalchowk District.
92
◄ Staff from the Water Supply Sanitation Division Office (WSSDO) and UNICEF during a meeting held under UNICEFsupported tent in Nuwakot District. The tent was handed to the WSSDO after their building was destroyed by the earthquake.
â–ź A UNICEF- provided tent functions as the office of the Water Supply Sanitation Division Office in Rasuwa District, which had been destroyed by the earthquake.
93
94
â—„â–ź Police constable Ram Pravesh Thakur stands in front of the UNICEF-provided tent being used by the police team in Chitlang village, Makwanpur District. The team live under the tent and also shifted their administrative work under the tent after their office, housed in a heritage buidling, was damaged by the earthquake.
95
â—„â–ź When the earthquake damaged the Health Post in Kharanitar of Nuwakot District, all its services, including its out-patient department(OPD) services were conducted under various tents. This tent in particular has a dual function. At the back is the sleeping quaters of the Health Officer on Duty, Dr. Ashish Shrestha, and in the front is where he examines and treats OPD patients. Here, he is attending to Ganga Gurung who had received stitches for a head wound, a week earlier.
96
â–ź Children of the women who are living in the shelterhome for pregnant, new and lactating mothers in Kharanitar Health Post premises in Nuwakot District have a special space in one of the tents which functions as their recreation corner.
97
â—„â–ź It was not just the tents that came in useful in the Health Posts, the sturdy boxes they came in, functioned as examining tables, and storage space for medical supplies.
98
â–˛ The kitchen for the shelter home in Kharanitar in Nuwakot District uses the tent boxes as counter-top place for utensils and vegetables.
99
z
◄ UNICEF-supplied tents also functioned as hostels for school children, like this one for students of Buddha Secondary School in Siridibas in Gorkha District.
100
◄ Boys with blindness studying in Chandeswori Higher Secondary School in Tupche village in Nuwakot District have been living on ‘hostel’ tents after their hostel building collapsed in the earthquake.
▲ In July 2015, when the Central Child Welfare Board (CCWB) and UNICEF decided to hold a media briefing on “Separated, Unaccompanied and other Vulnerable Children during Disasters,” they did so under the UNICEF tent in the CCWB premises in Lalitpur District.
101
The photographs included in this book were taken by: Brian Sokol Chandra Shekhar Karki Jan Zammit Kent Page Kiran Panday Krishna Saru Magar Nar Bahadur Budha Narendra Shrestha Prakash Mathema Prateek Rayamajhi Riaaj Narsingh Thapa Rupa Joshi Sundar Lama
Š United Nations Children’s Fund (UNICEF) Nepal Country Office Permission is required to reproduce any part of this publication. Permission will be freely granted to educational or nonprofit organizations. Published by: Communications Section, UNICEF Nepal UN House, Pulchowk, Lalitpur, Nepal August 2016